I don’t mind admitting my frustration on this one. I’d trained this person for nearly three years in my group fitness classes, The Fit Green, and she’d gone from strength to strength. Her circumstance changed.
She’d been made redundant from a company she had worked for for fifteen years plus and I put it down to stress and anxiety. Whilst I don’t think I was far off, I knew what to look for and I missed the vital signs.
I train many women in their forties and fifties and I pride myself on being familiar with common conditions synonymous with this demographic. She felt exhaustion and anxiety when doing a similar level of exercise she had done before. She felt breathless and talk about lethargy and low mood.
After a period of time she went to the doctor, who called it straight away. When she came back and told me it was clear. How could I miss it?!
The thyroid is a gland based at the bottom of your throat. It’s role is principally is to regulate your metabolism or basal metabolic rate - the speed at which you burn protein, fats and carbohydrate. Without stating the obvious, food fuels our body, but the rate at which you burn fuel differs from person to person. The thyroid has a huge influence over this, and so can determine if you have a ‘fast metabolism’ or a ‘slow metabolism’. Hence the frustration of many people with thyroid dysfunction - depending on if its hypo or hyper - you will struggle to lose weight or gain weight.
I perhaps need to qualify this further. It’s not that I completely disregard the energy balance equation (eat less + move more = weight loss), but the path from entrance to exit is subject to many challenging and different issues including digestive efficiency, hormone health, brain chemistry, cellular health, mindset, exercise intensity, sleeping patterns, allergies/ sensitivities, biochemical individuality... The list is endless. To think it’s just a case of ‘energy in versus energy out’ is simply crazy, and by definition so is counting calories. You only need to speak to someone with a thyroid issue to appreciate this.
The thyroid produces several hormones, however a couple seem more relevant than the others. This being said, it’s important to remember biology happens on a continuum. Looking into this I truly appreciate the sequence of rate determining steps that effect healthy hormones. This is why dealing with this issue is tricky.
The key hormones to be familiar with seem to be triiodothyronine (T3) and thyroxine (T4). These hormone help oxygen get into cells, and regulate metabolism. However, a number of transport proteins from the liver are needed to carry thyroid hormones through the blood to the cells. Obviously coming from the liver, the transport proteins are subject to a clean and healthy liver for safe and efficient transportation.
Every cell in the human body has a receptor for thyroid hormone. This is relevant because thyroid hormone is responsible for basic functions within the body, and can speed up metabolic reactions within every tissue. To emphasize this point a fractional drop in T4 can lead to 40% drop in basal metabolic rate (the rate at which your body burns calories). This can obviously cause you to gain weight quickly.
To use an analogy by performance nutritionist, Phil Richards, ‘one can imagine the thyroid gland as a furnace and the pituitary gland as the thermostat. Thyroid hormones are like heat. When the heat gets back to the thermostat, it turns the thermostat off.’
A healthy thyroid gland is regulated by a feedback system in your brain - the hypothalamus and pituitary gland - which make thyroid-releasing hormone (TRH) and thyroid-stimulating hormone (TSH). If it works as it should, your body will make what it needs and T4 will be converted to T3, in a synchronized loop maintaining balance.
One of the challenges with thyroid issues is diagnosis. You might not feel right, but the blood test might demonstrate something different. Like many things regarding your health there is an element of individuality. The medical profession has to draw the line somewhere and so a person might register a ‘normal’ score for one of the above hormones, but feel adverse symptoms, whilst someone might register an abnormal result and feel fine. You’ll need to listen to your body and consult with your doctor to get the treatment you need.
Furthermore, from what Bryan Walsh talks about in his Thyroid Repair Kit you’ll need to test for quite a few different aspects to get the clearest result. In this article alone I’ve mentioned T3, T4, TSH, TRH ...and that’s just the tip of the iceberg. You will need your doctor to take a variety of tests to know whats going on.
AND most importantly appreciating why you’ve an imbalance in the first place goes without saying. I’m certainly not against medication for this type of condition, but looking beyond medication you’ll notice several key factors - most notably chronic stress.
You need to appreciate an imbalance in one or more of the bodies systems will have an impact on another. In this case hormones are no different. Hormones work in cascades and thyroid hormones are subject to influence from your adrenal glands which are responsible for managing stress.
I’m not talking about the immediate and intense reaction you get from being chased by a lion (a daily occurrence here in Surrey). But more of the long slow drawn out chronic stress you get from working long hours, not going to bed on time, drinking too much coffee or wine, being in a bad relationship, etc. We’re not talking about adrenaline, we’re talking about cortisol and his many bedfellows.
A certain amount of stress is a good thing - it’s the very reason we get out of bed in the morning - but as Robert Sapolsky writes in his book Why Zebras Don’t Get Ulcers, chronic stress leads to adrenal exhaustion and is often connected with thyroid issues.
In this circumstance, taking thyroid medication in cases of prolonged chronic stress without addressing the stress is pointless. Your body needs cortisol to convert T4 to T3, too little (due to adrenal exhaustion) and the medication won’t work, too much and you’ll be thyroid resistant. The latter means the numbers will look normal on paper but will not actually be working at a cellular level.
I guess the resolve is simple in this circumstance, but not easy. To address stress you you’ve either got to deal with it, or learn to cope. I guess this might mean quitting your job, getting a divorce or putting your kids up for adoption! Or learning to appreciate stressors differently...
If you have a thyroid issue another area you might struggle with is oestrogen balance. Oestrogen - the female sex hormone - in simple terms causes food calories to be stored as fat. Thyroid hormones causes fat calories to be turned into usable energy. Therefore, as Phil Richards says, ‘thyroid hormones and oestrogen have opposing actions.’
The elevated oestrogen levels lead to increased production of thyroid-binding globulin (TBG) by the liver. Elevated levels of TBG will bind to thyroid hormones and the reduce the free thyroid hormones in the blood. This will means it cannot connect with the cells and elevate metabolism.
You can have elevated oestrogen levels for many reasons but in my experience the first step is to eliminate processed foods and improve liver function. Further to this I’d suggest eating more green leafy vegetables.
In terms of nurturing your thyroid back to good health I’d express caution in reducing calories. Your thyroid will work against you. It will slow your metabolism further. Fasting-style diets and restricted calorie diets reduce thyroid hormones. Similarly too few carbohydrates seem to disrupt thyroid hormones too. Therefore a small amount of carbohydrate seems to be necessary.
With best quality proteins (...think meats, poultry and fish) adequate amounts of healthy fats are important too. Look at coconut oil, or more specifically lauric acid, found in coconut oil, for stabilizing blood sugar and increasing satiety after meals.
You’ll find a few key nutrients are connected with optimum function. Most notably iodine and L-tyrosine to convert T4 to T3. Iodine deficiency is widely regarded as the number one reason for hypothyroidism, and can be found in salt-water fish, seaweed, sea vegetables and shellfish. And L-tyrosine, an amino acid, can be found in good quality sources of protein. I’m sure you’ll recognise the difficulty of calculating exactly how much of each nutrient you get and so I’d encourage you to look at supplementation to get more exact doses.
I’m sure by the very brief bio I’ve already written about this challenging hormone, you’ll appreciate the varying cofactors are subject to nourishment from specific nutrients too. These include selenium, copper, magnesium, niacin, riboflavin, vitamin B6 and zinc. Deficiency in one or more of the above can effect healthy thyroid function.
...I guess this article got away from me a little! The key points to consider are firstly to consider liver function - to do this eat nourishing healthy food and drink water/ herbal tea. Second take stress seriously - either deal with it or learn to cope better. Thirdly I’d take rest seriously - I guess this will sound counterintuitive - but if you’re stressed this is important - learn to rest! Fourthly look at supplementing to give your body a little support.
For further reading I definitely recommend Phil Richards Ultimate Fat Loss Manual and maybe look at Bryan Walsh’s Thyroid Repair Kit. Or more generally a great book is Paul Chek’s How To Eat Move and Be Healthy.
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